Psychotherapy

Synopsis of Frankl’s Life:
Viktor Emile Frankl was born in a Jewish family of civil servants in Vienna on 26 March 1905. He trained to become a neurologist and psychiatrist and in 1924, he became president of the Sozialistische Mittelschuler Osterreich where he counselled students (not a single student committed suicide while he held this post and then in 1933 moved Berlin after this success and headed the Selbstmorder Pavilion (the suicide pavilion) of the General Hospital in Vienna and treated over 30,000 women. He stayed here till 1937.1938 he was prohibited from treating Aryan patients due to his Jewish ethnicity. In December 1941 married Tilly Grosser. On 25 September 1942 him and his family were arrested and taken to the concentration camp of Theresienstcidt. On 19 October 1944 he was transported to Auschwitz and stayed there till 27 April 1945 only him and his sister surviving. In 1947 married his second wife. Throughout his life he wrote over 32 books and lectured at Harvard and Vienna and received 29 honorary doctorate degrees.

Introduction

Oscar Wilde, in his work, The Ballad of Reading Gaol, wrote: “Nothing in the whole world is meaningless, suffering least of all”. This is the central theme to Frankl and to Logotherapy. That meaning can be found through suffering and that it ceases to be suffering at the moment it finds meaning. What matters is the stand one takes. His attitude towards facts rather than the circumstances themselves is what’s important. Frankl’s optimism does not deter his argument that man has to accept his finiteness in its triad. Throughout his work he highlights that man needs to face the fact that he has failed, he is suffering and that he will die. He says it has become easy to blame existential philosophy for over emphasising the tragic aspects of human existence, and though it centres on issues such as death and suffering it is not pessimistic and that man has to deal with the tragedy of human existence and not allow them to be blurred or clouded by the doctor he visits. He rightfully reminds us that dying, pain and guilt are not inventions of Logotherapy or Existentialism, but state of affairs which belong to the human condition.

What threatens man is his guilt in the past and his death in the future. Both are inescapable and both must be accepted. It is this, when properly understood which adds to life’s worthwhileness, since only in the face of guilt does it make sense to improve, and only in the face of death is it meaningful to act. If man were immortal he would be justified in delaying everything. Frankl sees that existential guilt is simply inherent in the human condition.

After Freud’s psychoanalysis and Adler’s individual psychology, Logotherapy comes as the “third Viennese school of psychotherapy”. It is Existential analysis that focuses on a “will to meaning” as opposed to Adler’s Nietzschian doctrine of “will to power” or Freud’s “will to pleasure”. The concept of Logotherapy is contrary to Freud’s Pleasure Principle and to Adler’s Power Principle. Logotherapy insists that mans main concern is not to seek pleasure or to avoid pain, but to find a meaning to life. Thus we see man is ready to suffer if only he can be satisfied that his suffering has meaning. It is a Stoic philosophy in that it holds that no matter the state of the world, the attitude we chose is what helps. The Stoic Epictetus held that “men are not moved by events but by their interpretation”. Many motivational speakers and self help gurus have taken this stance in their lectures and books; a prime example of this is Anthony Robbins (Awaken the Giant Within).

“Logos”, the Greek word meaning “rational order” is not the meaning intended for Frankl’s Logotherapy. For this form of existential therapy, Logos is taken to translate into “meaning”, help through meaning. Existential Analysis is the philosophical and scientific basis of Logotherapy. The therapy is the natural result of Frankl’s existential theories on man’s search for meaning. The therapy is rooted in three philosophical concepts: Freedom of will, Will to meaning and Meaning in life. Of Logotherapy, Frankl says: “Logotherapy is not only concerned with being, but with meaning (ontos and logos). This feature accounts for the activistic, therapeutic orientation of Logotherapy. Not only an analysis, but also a therapy”.

Freedom of Will is based on the belief that humans are not entirely products of environmental or biological conditions but have the freedom to decide and that this freedom is the space in which the person has to shape their own life within the limits of the possibilities available to him. This philosophical concept relies on the spiritual dimensions of the person which he believes has power over the body and psyche. It is a strong argument in that is gives the patient room for autonomous action no matter the circumstances or what they are facing, be it somatic or psychological ill health. It also empowers the patient to have a more positive attitude, making them feel they are in a position to regain control and indeed can exercise self determination.

The second philosophical concept the therapy is based on, Will to Meaning, goes one step further to argue that we are not only free, but free to achieve goals and purposes and that the frustration of the existential need for meaningful goals will give rise to aggression, addiction, depression and suicidiality, and it may increase neurotic disorders and that if we know this, then we are on the right track for discovering better ways to fulfil the meanings we are searching for by understanding and removing obstacles that stand in the way of them pursuing meaningful goals in our lives. Though this appears to be susceptible to the criticism of being directive in an almost unethical fashion, it is important to point out that the patient is only guided while detecting these meanings themselves. Frankl says: “the meaning of our existence is not invented by ourselves, but rather detected”.

Finally, the third philosophical point, Meaning in Life, helps Logotherapy base itself on the idea that meaning is an objective reality. This is very different to how occupational and recreational therapies work by diverting the patient’s attention from unpleasant experiences. Logotherapy does not shy away from this. On the grounds of their freedom and responsibility, patients are encouraged to bring out the possible best in themselves and in the world by perceiving and realising the meaning of the moment in each and every situation, its pains along with its joy. Frankl says: “Logotherapy… considers man as a being whose main concern consists in fulfilling a meaning and in actualising values, rather than in the mere gratification and satisfaction of drives and instincts”.

There are three therapeutic techniques used in Logotherapy. Paradoxical Intention (used mainly for compulsive disorders, anxiety and vegetative syndromes), Deflection, or shifting of focus (used for sexual disorders, sleeplessness and anxiety disorders), and finally Socratic dialogue, or modification of attitudes (used for certain attitudes and expectations} obstacles to meaning fulfilment which can alienate a person from the meaning potentialities in their life (neurotic disorders).

In Paradoxical Intention, the patient is guided by the therapist to learn to overcome their obsessions or anxieties by self distancing and humorous exaggeration (a prime example of this on a large scale is the Egyptian humour, where any tragedy which hits the country is followed by a wide spread array of jokes repeated), thus breaking the vicious circle of symptom and symptom amplification. Deflection involves instinctive, automatic processes being impeded and hindered by exaggerated self observation. Some mild and well founded sensations of anxiousness or sadness will be increased and amplified by self observation. It is the purpose of de reflection to break the neuroticizing circle by drawing the patient’s attention away from the symptom or the naturally flowing process. The final technique, Socratic Dialogue, has been described by some as “spiritual midwifery”. It is a controversial method where questions are aimed to raise into consciousness the possibility to find, and the freedom to fulfil, meaning in one’s life. This is definitely the most directive of the three.

Meaning through creative values, Meaning through experiential values and Meaning through attitudinal values are the three ways the therapist tries to enlarge the patient’s understanding of meaning. Of the first, Frankl says: “the Logotherapist role consists in widening and broadening the visual field of the patient so that the whole spectrum of meaning and values becomes conscious and visible to him”. Of the second, Meaning through experiential values, Frankl says: “let us ask a mountain-climber who has beheld the alpine sunset and is so moved by the splendour of nature that he feels cold shudders running down his spine – let us ask him whether after such an experience his life can never again seem wholly meaningless”. Frankl uses the famous dialogue between himself and an old doctor who had recently lost his wife to highlight the use of meaning through attitudinal values:

Frankl: What would have happened if you had died first and your wife had survived you?
Man: oh, for her this would have been terrible, she would have suffered
Frankl: you see, such a suffering has been spared her and it is you who have spared her this suffering, but now, you have to pay for it by surviving her and mourning her” (MSFM)

There are two main attempts at developing Logotherapy after Frankl’s death that are worth mentioning at this point. The first involves James Crumbaugh through his “Purpose in Life Test”. Here he attempts to focus on values and meanings more systematically so that the foundation becomes more scientific than Frankl’s traditional methods. The other involves Wong and Fry and The Human Quest for Meaning, written in 1998, again, another attempt to deal with Logotherapy on a scientific basis.

Frankl’s reinsertion of religion into psychology is a point of huge controversy. However, it is important to understand it in the subtlety which Frankl intended. He made clear in almost all his writings that the God he refers to is not the God of institutional religion but of the inner human, a God he believes agnostics could accept through the use of the word Transcendence rather than God. He says: “This unconscious religiousness, revealed by our phenomenological analysis, is to be understood as a latent relation to transcendence inherent in man. If one prefers, he might conceive of this relation in terms of a relationship between the immanent self and the transcendent thou”. It is this which Frankl calls transcendence and contrasts it with self actualisation as Maslow uses the term. Self actualisation, even pleasure and happiness, are side effects of self transcendence and the discovery of meaning. For Frankl, the spirit is the will of the human being. The emphasis therefore, is on the search for meaning and not the search for God. Though for some this may bare a resemblance to Jung, we must remember that Frankl’s “unconscious God” is unlike the archetypes Jung discusses. Frankl’s God is transcendent yet personal.

It is interesting to see what other existential thinkers made out of “meaning” and its importance in therapy. The biggest difference is seen between Frankl and Sartre. Frankl’s existentialism is set apart from the existentialism of the likes of Jean Paul Sartre and other atheistic existentialists who suggest that life is ultimately meaningless and we must find the courage to face that meaninglessness. This is because ultimately, experiential, attitudinal values are simply surface manifestations of something more fundamental. What he calls Supra Meaning or Transcendence means there is ultimate meaning in life, meaning that is not dependent on others, on our projects, or even on our dignity. It is a reference to God. Sartre says we must learn to endure ultimate meaninglessness; Frankl instead says that we need to learn to endure our inability to fully comprehend ultimate meaningfulness for “Logos is deeper than logic”.

Another one of the major contrasts is between Frankl and Freud. Their differences are best seen in a selection of quotes. In Man’s Search for Meaning, Frankl says: “In spite of all the enforced physical and mental primitiveness of the life in the concentration camp, it was possible for spiritual life to deepen… they were able to retreat from their terrible surroundings to a life of inner riches and spiritual freedom”. Freud, in The Future of an Illusion says: “Religion is the universal compulsive neurosis of mankind (1975, p69) and in a letter Freud wrote to Princess Bonaparte, he states: “The moment a man questions the meaning and value of life, he is sick”.

There are writers who have completely different approaches and contributions to existentialism, but share views similar to Frankl on meaning. One of these is Erich Fromm who suggests man makes his life meaningful by living productively and by using his powers of love and reason to the full capacity. There is some resemblance here to Frankl. Abraham Maslow sees meaning being experienced by the self actualised, growth motivated person who delights in using his creative powers for their own sake and who can affirm himself and simultaneously transcend himself through peak experiences. Rollo May argues that meaning is experienced by a person centred in him-self, who is able to live by his highest values, who knows his own intentionality, feels the power of his will to choose and is able to love. Abraham Heschel saw that man experiences his life as meaningful when he lives in God’s presence not simply by encountering God in the world, but primarily by serving God in everyday life. And by allowing oneself to experience or trust in an ultimate meaning which we may or may not call God. His theory has a much heavier religious undertone than Frankl.

Another point Frankl makes which is open to debate is his argument that the “age of Existential Vacuum is where man is not being burdened enough…Tension is not something to be avoided. Existential dynamics exist in the field of tension established between what man is and what he ought to do.” Though, this has wider feeling of acceptance when he says on the same subject “… for too long now we have been dreaming a dream from which we are now waking up: the dream the dream that if we just improve the socioeconomic situation of people, everything will be ok, people will become happy. The truth is that as the struggle for survival has subsided, the question has emerged: survival for what? Ever more today, people have the means to live, but no meaning to live for”, in another of his papers he writes: “what man actually needs is not a tensionless state but rather the striving and struggling for some goal worthy of him”. The argument that science is taking away more from man than that which is gives him is a theme shared across the existentialists.

One of the strengths of Frankl’s is that Mans quest for meaning should be taken at face value and not tranquilised or analysed away even though he sees the use of ECT, drugs and lobotomies as valuable. He writes often that in 1952 he developed the first tranquilizer in Continental Europe and carried out lobotomies himself which he never went on to regret. Frankl says to theologians: Logotherapy, as a secular practice and theory, which it is, refrains from leaving the boundaries of medical science.

There is much other strength attributed to Frankl’s existential theories. Of these, the most prominent of include the inspiration of Frankl’s personal life. He is writing a theory on abstract experience but experience he has suffered and survived. Compared to many other therapies, Logotherapy is simple to understand and if the person undertaking it has faith in it, then the therapy is potentially life changing. The therapy does not set to take away from others, however it does address dimensions to a human’s suffering which are not dealt with by other therapies and compared to other therapies and theories, and a man’s search for meaning through Logotherapy is the more optimistic and productive.

The above does, however, go hand in hand with limitations that need to be highlighted to provide an objective overview of the therapy. It cannot be denied that the most prominent of these is that the therapy is too authoritarian and far more directive than most others. For some, it can be construed as too religious and not sufficiently scientific having reinserted religion back in psychology. To some this may be seen as a regression in any advancement in psychology and the sciences of the mind. Those who fear trends such as pop psychology and the myths they are usually based on will also highlight that the therapy is too dependent on Frankl and his intuitions and experience, resulting in interpretations being too narrow and simplistic.

He says the barriers to humanity’s quest for meaning in life is “affluence, hedonism and materialism”

He knows the “why” for his existence and will be able to bear almost any “how”.

Note to my Readers

Thank you for taking the time to read my ramblings between different cities, especially London and Cairo - the two very different places I call home.

My name is Nelly Ali, I am Lecturer and a PhD student in the department of Geography, Environment and Development. I have an LLM in Human Rights and wrote my dissertation on Freedom of Expression in Egypt in 2004. My current research is with Street Children in Cairo.

I lecture on Childhood Studies at the Institute of Education, Roehampton University, Birkbeck College, University of London and Anglia Ruskin University. I am also an active commentator on the socio-political situation in Egypt and I am passionate about street children.